A Survey to Determine the Use of Simulation for the Training of US Pediatric Residents
Date survey distributed to APPD membership (eg., 3/2015):
Portion of APPD membership surveyed (eg., Program Directors and Associate Program Directors):
The survey went out to Program Directors to give to the person in their program with the most knowledge of the resident simulation program at their institution.
Response rate (eg., 50%; 99/198):
Summary of main findings:
1. Use of simulation in training: All of the programs which responded have a simulation program in place for their residents; a mode of 5 simulation experiences were reported per program. Qualitative analysis of this data demonstrated that there was a group of experiences that were commonly reported and another group which were rarely reported. The common experiences were procedural simulation, mock codes, urgent situations, and communication simulation. The rarer experiences were those that focused on teamwork, boot camps, competency assessment, ethics, and contingency planning for patients the residentss patients. 2. How is simulation used: When asked how simulation is being used beyond for teaching purposes, 72% programs are using it for meeting procedural requirements, 69% for research, 62% for QI, 47% for remediating struggling learners, 38% for assessing resident competency (as on the milestones) and 9% for assessing residents for advancement to the next year of training. 3. Effectiveness of the simulation program: In response to the question of how programs assess the effectiveness of their simulation programs, 93.8% of respondents said they use learner feedback, 71.9% subjective assessment of resident improvement in performance (i.e. improved professionalism, communication, perceived knowledge), 52.1% procedure logging, 50% the ACGME annual survey, 25% objective assessment of resident performance (i.e. decreased time to successful intubation), and 21.9% resident performance on established and ongoing evaluation curriculum. When asked how confident the respondent is that their simulation program improves residents sense of preparedness 13.8% said they were extremely confident, 34.5% quite, 44.8% moderately, 6.9% slightly, and none said not at all. When asked how confident respondents are that their simulation program improves resident competence, 6.3% said extremely, 31.3% quite, 47% moderately, 12.5% slightly, and 3.1% not at all. 4. Challenges to simulation: Qualitative analysis of respondents three biggest challenges to implementing simulation led to 5 overarching categories: time, physical resources, expertise, competing priorities, logistics, and buy-in. Overall, it seems that simulation is being widely used in common ways and that collaboration nationally across programs would benefit programs in terms of understanding and creating best-practices and evidence-based uses of simulation.
We plan to present this work at the spring APPD meeting in 2020 at the Healthcare Simulation Learning Community Meeting as well as presenting it in poster form at the meeting.
We are currently writing a manuscript of our findings for publication.